{"id":2887,"date":"2017-03-16T15:36:19","date_gmt":"2017-03-16T14:36:19","guid":{"rendered":"https:\/\/www.servethecity.brussels\/donate\/"},"modified":"2023-03-31T12:03:23","modified_gmt":"2023-03-31T10:03:23","slug":"donate","status":"publish","type":"page","link":"https:\/\/www.servethecity.brussels\/fr\/donate\/","title":{"rendered":"Faire un don"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row fullwidth=\u00a0\u00bbtrue\u00a0\u00bb fullwidth_content=\u00a0\u00bbfalse\u00a0\u00bb css=\u00a0\u00bb.vc_custom_1580331244408{padding-top: 30px !important;padding-bottom: 30px !important;background-color: #0098db !important;}\u00a0\u00bb el_class=\u00a0\u00bbwhite\u00a0\u00bb][vc_column][mk_fancy_title color=\u00a0\u00bb#ffffff\u00a0\u00bb size=\u00a0\u00bb48&Prime; font_weight=\u00a0\u00bb300&Prime; letter_spacing=\u00a0\u00bb1&Prime; margin_top=\u00a0\u00bb30&Prime; margin_bottom=\u00a0\u00bb40&Prime; font_family=\u00a0\u00bbnone\u00a0\u00bb align=\u00a0\u00bbcenter\u00a0\u00bb]\n<p style=\"text-align: center;\">Pour servir la ville, nous avons besoin de votre aide.<\/p>\n[\/mk_fancy_title][mk_fancy_title tag_name=\u00a0\u00bbh3&Prime; color=\u00a0\u00bb#ffffff\u00a0\u00bb size=\u00a0\u00bb20&Prime; font_weight=\u00a0\u00bb300&Prime; margin_top=\u00a0\u00bb20&Prime; margin_bottom=\u00a0\u00bb0&Prime; font_family=\u00a0\u00bbnone\u00a0\u00bb align=\u00a0\u00bbcenter\u00a0\u00bb]\n<p>Serve the City d\u00e9pend du d\u00e9vouement inlassable de milliers de volontaires qui investissent leur temps \u00e0 s\u2019occuper des personnes n\u00e9cessiteuses. Nous d\u00e9pendons \u00e9galement des contributions financi\u00e8res volontaires vers\u00e9es par vous.<\/p>\n[\/mk_fancy_title][mk_fancy_title tag_name=\u00a0\u00bbh3&Prime; color=\u00a0\u00bb#ffffff\u00a0\u00bb size=\u00a0\u00bb20&Prime; font_weight=\u00a0\u00bb600&Prime; margin_top=\u00a0\u00bb10&Prime; margin_bottom=\u00a0\u00bb50&Prime; font_family=\u00a0\u00bbnone\u00a0\u00bb align=\u00a0\u00bbcenter\u00a0\u00bb]\n<p>Et si \u00a0vous nous donnez 40 \u20ac ou plus par an, vous recevrez une r\u00e9duction d&rsquo;imp\u00f4t (<a href=\"#FAQ\">voir FAQ plus bas<\/a>).<\/p>\n[\/mk_fancy_title][\/vc_column][\/vc_row][mk_page_section layout_structure=\u00a0\u00bbhalf_right\u00a0\u00bb bg_image=\u00a0\u00bbhttps:\/\/servethecity.azureedge.net\/wp-content\/uploads\/sites\/2\/2010\/05\/img_3722-e1474386979379.jpg\u00a0\u00bb bg_stretch=\u00a0\u00bbtrue\u00a0\u00bb full_width=\u00a0\u00bbtrue\u00a0\u00bb padding_top=\u00a0\u00bb50&Prime;][vc_column]<script type=\"text\/javascript\">\n\/* 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 action='\/fr\/wp-json\/wp\/v2\/pages\/2887#gf_136' data-formid='136' novalidate><div id=\"payments-sdk__contingency-lightbox\"><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_136' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_136_43\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_136_43'>Phone<\/label><div class='gfield_description' id='gfield_description_136_43'>Ce champ n\u2019est utilis\u00e9 qu\u2019\u00e0 des fins de validation et devrait rester inchang\u00e9.<\/div><div class='ginput_container'><input name='input_43' id='input_136_43' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_136_30\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Faire un don<\/h3><\/div><fieldset id=\"field_136_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full radio_frequency gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Fr\u00e9quence<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_136_9'>\n\t\t\t<div class='gchoice gchoice_136_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Give one time'  id='choice_136_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_9_0' id='label_136_9_0' class='gform-field-label gform-field-label--type-inline'>Donner une seule fois<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Give monthly' checked='checked' id='choice_136_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_9_1' id='label_136_9_1' class='gform-field-label gform-field-label--type-inline'>Donner mensuellement<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_136_10\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-full radio_amounts gfield_price gfield_price_136_10 gfield_product_136_10 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Quel est le montant de votre don ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_136_10'>\n\t\t\t<div class='gchoice gchoice_136_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='25|25'  id='choice_136_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_10_0' id='label_136_10_0' class='gform-field-label gform-field-label--type-inline'>25 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='50|50' checked='checked' id='choice_136_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_10_1' id='label_136_10_1' class='gform-field-label gform-field-label--type-inline'>50 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_10_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='100|100'  id='choice_136_10_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_10_2' id='label_136_10_2' class='gform-field-label gform-field-label--type-inline'>100 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_10_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='250|250'  id='choice_136_10_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_10_3' id='label_136_10_3' class='gform-field-label gform-field-label--type-inline'>250 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_10_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Other amount|0'  id='choice_136_10_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_10_4' id='label_136_10_4' class='gform-field-label gform-field-label--type-inline'>Autre montant<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_136_3\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-full radio_amounts gfield_price gfield_price_136_3 gfield_product_136_3 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Quel est le montant de votre don ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_136_3'>\n\t\t\t<div class='gchoice gchoice_136_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='10|10'  id='choice_136_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_3_0' id='label_136_3_0' class='gform-field-label gform-field-label--type-inline'>10 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='25|25' checked='checked' id='choice_136_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_3_1' id='label_136_3_1' class='gform-field-label gform-field-label--type-inline'>25 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_3_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='50|50'  id='choice_136_3_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_3_2' id='label_136_3_2' class='gform-field-label gform-field-label--type-inline'>50 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_3_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='100|100'  id='choice_136_3_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_3_3' id='label_136_3_3' class='gform-field-label gform-field-label--type-inline'>100 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_3_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Other amount|0'  id='choice_136_3_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_3_4' id='label_136_3_4' class='gform-field-label gform-field-label--type-inline'>Autre montant<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_136_4\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full input_amount gfield_price gfield_price_136_4 gfield_product_136_4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_136_4'>Veuillez indiquer le montant<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_4' id='input_136_4' type='text' value='' class='large ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><fieldset id=\"field_136_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Organisation<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_136_24'><div class='gchoice gchoice_136_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='This donation is on behalf of an organisation'  id='choice_136_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_136_24_1' id='label_136_24_1' class='gform-field-label gform-field-label--type-inline'>Ce don est fait au nom d'une organisation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_136_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations sur l&#039;organisation<\/h3><\/div><div id=\"field_136_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_136_25'>Nom de l&#039;organisation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_136_25' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_136_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_136_26'>Num. d&#039;entreprise<\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_136_26' type='text' value='' class='large'  aria-describedby=\"gfield_description_136_26\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_136_26'>Facultatif<\/div><\/div><fieldset id=\"field_136_27\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Adresse de l&#039;organisation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_136_27' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_136_27_1_container' >\n                                        <label for='input_136_27_1' id='input_136_27_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                        <input type='text' name='input_27.1' id='input_136_27_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_136_27_3_container' >\n                                    <label for='input_136_27_3' id='input_136_27_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                    <input type='text' name='input_27.3' id='input_136_27_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_27.4' id='input_136_27_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_136_27_5_container' >\n                                    <label for='input_136_27_5' id='input_136_27_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                    <input type='text' name='input_27.5' id='input_136_27_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_136_27_6_container' >\n                                        <label for='input_136_27_6' id='input_136_27_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                        <select name='input_27.6' id='input_136_27_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' selected='selected'>Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kosovo' >Kosovo<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_136_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Vos informations<\/h3><\/div><fieldset id=\"field_136_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Votre nom<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_136_1'>\n                            \n                            <span id='input_136_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_136_1_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_1.3' id='input_136_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_136_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_136_1_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_1.6' id='input_136_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_136_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_136_2'>Votre adresse courriel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_136_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_136_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_136_35'>Contact ID<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_136_35' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_136_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_40' id='input_136_40' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_136_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--has-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Fournir l&#039;adresse<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_136_28'><div class='gchoice gchoice_136_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='I would like to provide my Belgian National Register number and address for tax purposes'  id='choice_136_28_1'   aria-describedby=\"gfield_description_136_28\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_136_28_1' id='label_136_28_1' class='gform-field-label gform-field-label--type-inline'>I would like to provide my Belgian National Register number and address for tax purposes<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_136_28'>Il est toujours possible de le fournir ult\u00e9rieurement par le biais de l'e-mail de confirmation.<\/div><\/fieldset><div id=\"field_136_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_136_41'>Belgian National Register Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_136_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_136_42\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_136_42' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_136_42_1_container' >\n                                        <label for='input_136_42_1' id='input_136_42_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                        <input type='text' name='input_42.1' id='input_136_42_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_136_42_3_container' >\n                                    <label for='input_136_42_3' id='input_136_42_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                    <input type='text' name='input_42.3' id='input_136_42_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_42.4' id='input_136_42_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_136_42_5_container' >\n                                    <label for='input_136_42_5' id='input_136_42_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                    <input type='text' name='input_42.5' id='input_136_42_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_136_42_6_container' >\n                                        <label for='input_136_42_6' id='input_136_42_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                        <select name='input_42.6' id='input_136_42_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' selected='selected'>Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kosovo' >Kosovo<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_136_33\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations de paiement<\/h3><\/div><fieldset id=\"field_136_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full radio_payment gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >M\u00e9thode de paiement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_136_12'>\n\t\t\t<div class='gchoice gchoice_136_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Credit Card'  id='choice_136_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_12_0' id='label_136_12_0' class='gform-field-label gform-field-label--type-inline'>Carte de cr\u00e9dit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Paypal'  id='choice_136_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_12_1' id='label_136_12_1' class='gform-field-label gform-field-label--type-inline'>Paypal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_136_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Bank Transfer' checked='checked' id='choice_136_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_136_12_2' id='label_136_12_2' class='gform-field-label gform-field-label--type-inline'>Virement bancaire<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_136_5\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_136_ gfield_total gfield_total_136_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_136_5'>Total<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_5' id='input_136_5' value='0,00 &#8364;' class='gform-text-input-reset ginput_total ginput_total_136' \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_136_13\" class=\"gfield gfield--type-stripe_creditcard gfield--input-type-stripe_creditcard gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--type-stripe_creditcard-card\"  ><label class='gfield_label gfield_label_before_complex gform-field-label' for='input_136_13_1'>Carte de cr\u00e9dit<\/label><div class='ginput_complex ginput_container ginput_container_creditcard ginput_stripe_creditcard gform-grid-row' id='input_136_13'><div class='ginput_full gform-grid-col' id='input_136_13_1_container' data-payment-element='false'><label for='input_136_13_1' id='input_136_13_1_label' class='gform-field-label gform-field-label--type-sub'>D\u00e9tails de la carte<\/label><div id='input_136_13_1' class='gform-theme-field-control StripeElement--card'><\/div><\/div><!-- .ginput_full --><div class='ginput_full gform-grid-col' id='input_136_13_5_container'>\r\n\t\t\t\t\t<label for='input_136_13_5' id='input_136_13_5_label' class='gform-field-label gform-field-label--type-sub'>Nom du titulaire de la carte<\/label>\r\n\t\t\t\t\t<input type='text' name='input_13.5' id='input_136_13_5' value=''>\r\n\t\t\t\t<\/div><\/div><!-- .ginput_container -->\r\n\t\t\t<style type=\"text\/css\">\r\n\t\t\t\t:root {\r\n  \t\t\t\t\t--link-login-string: \"Connexion Link\"\r\n\t\t\t\t}\r\n\t\t\t<\/style><\/div><div id=\"field_136_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p><small><strong>Remarque:<\/strong> Toutes les transactions par carte de cr\u00e9dit sont trait\u00e9es par <a href=\"https:\/\/www.stripe.com\" target=\"_blank\">Stripe<\/a>. Nous ne stockons aucun num\u00e9ro de carte sur nos serveurs. <br>\r\nDe plus, notre site Serve the City est chiffr\u00e9 \u00e0 l'aide d'un certificat SSL issu par Let's Encrypt (ce que vous pouvez voir grace \u00e0 l'ic\u00f4ne du cadena en fonction de votre navigateur), assurant que toute communication entre votre navigateur et les serveurs sont s\u00e9curis\u00e9es.<\/small><\/p><\/div><fieldset id=\"field_136_36\" class=\"gfield gfield--type-paypal gfield--input-type-paypal gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gform_ppcp_custom_card_fields\"  data-field-class=\"gform_ppcp_custom_card_fields\" ><legend class='gfield_label gfield_label_before_complex gform-field-label' for='input_136_36_1' ><label class='gfield_label gform-field-label'>M\u00e9thode de paiement<\/label><\/legend><div class='ginput_container ginput_container_select gform_ppcp_payment_method' style=\"display:none;\"><select name='input_36.6' id='input_36_6' class='medium gfield_select' ><option value='PayPal Checkout' selected='selected'>PayPal Checkout<\/option><\/select><\/div><div class='ginput_complex ginput_container ginput_container_custom_card_fields gform-grid-row' id='input_136_36' style=\"display:none;\"><span class='ginput_full gform-grid-col' id='input_136_36_1_container' >\n                                    <div class='gform_card_icon_container gform_card_icon_style1'><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_136_36_supported_creditcards'>Cartes bancaires prises en charge\u00a0: MasterCard, Visa<\/span><\/div>\n                                    <label for='input_136_36_1' id='input_136_36_1_label'  class='gform-field-label gform-field-label--type-sub'>Num\u00e9ro de carte<\/label>\n                                    <span id='input_136_36_1' class='ginput_card_field ginput_card_number gform-theme-field-control'><\/span>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_136_36_2_container'>\n                                            <span class='ginput_cardinfo_left gform-grid-col' id='input_136_36_2_cardinfo_left'>\n                                                <label for='input_136_36_2'  class='gform-field-label gform-field-label--type-sub'>Date d\u2019expiration<\/label>\n                                                <span id='input_136_36_2' class='ginput_card_field ginput_card_expiration gform-theme-field-control'><\/span>\n                                            <\/span><span class='ginput_cardinfo_right gform-grid-col' id='input_136_36_2_cardinfo_right'>\n                                                <label for='input_136_36_3'  class='gform-field-label gform-field-label--type-sub'>Code de s\u00e9curit\u00e9 (CVC)<\/label>\n                                                <span id='input_136_36_3' class='ginput_card_field ginput_card_security_code gform-theme-field-control'><\/span>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_136_36_5_container'>\n                                            <label for='input_136_36_5' id='input_136_36_5_label'  class='gform-field-label gform-field-label--type-sub'>Nom du titulaire de la carte<\/label>\n                                            <input type='text' name='input_36.5' id='input_136_36_5' value=''  \/>\n                                        <\/span> <\/div><\/fieldset><div id=\"field_136_15\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Vous avez choisi PayPal comme m\u00e9thode de paiement. Lorsque vous cliquerez sur DONNER MAINTENANT, vous serez redirig\u00e9 vers la page de Paypal pour confirmer votre don.<\/p>\r\n<p>V\u00e9rifiez toujours que la page sur laquelle vous vous connectez \u00e0 Paypal commence par https:\/\/www.paypal.com.<\/p><\/div><div id=\"field_136_34\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Vous avez choisi le virement bancaire comme mode de paiement. Voici nos coordonn\u00e9es bancaires (qui vous seront \u00e9galement envoy\u00e9es par e-mail lors de l'envoi du formulaire).<\/p>\n<table>\n<tbody>\n<tr>\n<td><b>Serve the City ASBL<\/b><br>\n229 Avenue de la Couronne<br>\n1050 Ixelles<\/td>\n<td><b>IBAN: <\/b>BE45 5230 8122 9289<br>\n<b>BIC: <\/b>TRIOBEBB <small>(Banque Triodos)<\/small><br>\n<b>TVA:\u00a0<\/b>BE0886.257.326<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div><fieldset id=\"field_136_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full privacypolicy gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Politique de Protection des Donn\u00e9es<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_136_21'><div class='gchoice gchoice_136_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='I have read and agree to the &lt;a href=&quot;\/privacy-policy\/&quot; target=&quot;_blank&quot;&gt;Privacy Policy&lt;\/a&gt; and authorise Serve the City to store my information securely.'  id='choice_136_21_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_136_21_1' id='label_136_21_1' class='gform-field-label gform-field-label--type-inline'>J'ai lu et approuv\u00e9 <a href=\"https:\/\/www.servethecity.brussels\/fr\/data-protection-policy\/\" target=\"_blank\"> la politique de protection de donn\u00e9es <\/a> et authorise Serve the City \u00e0 stocker mes information en toute s\u00e9curit\u00e9.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_136_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_136_38'>Posted<\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_136_38' type='text' value='Posted' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_136_39\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_136_39'>Pledged<\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_136_39' type='text' value='Pledged' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_136' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Faites un don'  \/><div id=\"gform_ppcp_smart_payment_buttons_136\" class=\"medium gform_ppcp_smart_payment_buttons\"><\/div> <input type='hidden' name='gform_ajax' value='form_id=136&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=b1f2183ad147d9b302958af1ecf02a84' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_136' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_136' id='gform_theme_136' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_136' id='gform_style_settings_136' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_136' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='136' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='6SLPbxwc7TLpFOZaAzFuDBm2sE6\/dWG3j9PmlC+BZzY4Tjx4ET\/B29TcPpHDKSQrVavMIBsKzaPpe97PePm+7\/rZ6t1iY0MqG2ZS2bTmIr7Os9s=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_136' 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don ?<\/h2>\n[\/vc_column_text][mk_padding_divider size=\u00a0\u00bb20&Prime;][vc_row_inner][vc_column_inner width=\u00a0\u00bb1\/3&Prime;][mk_icon_box style=\u00a0\u00bbsimple_ultimate\u00a0\u00bb rounded_circle=\u00a0\u00bbtrue\u00a0\u00bb icon_location=\u00a0\u00bbtop\u00a0\u00bb icon_color=\u00a0\u00bb#81d742&Prime; box_blur=\u00a0\u00bbfalse\u00a0\u00bb]Sur le plan financier, nous d\u00e9pendons des aides financi\u00e8res issues de nos team-buildings, de nos collectes de fonds et celles vers\u00e9es par les donateurs priv\u00e9s. Nous finan\u00e7ons la majeure partie de notre engagement gr\u00e2ce aux dons faits par vous. Ainsi, nos 2.000 volontaires peuvent se consacrer \u00e0 servir la ville.[\/mk_icon_box][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/3&Prime;][mk_icon_box style=\u00a0\u00bbsimple_ultimate\u00a0\u00bb rounded_circle=\u00a0\u00bbtrue\u00a0\u00bb icon_location=\u00a0\u00bbtop\u00a0\u00bb icon_color=\u00a0\u00bb#dd9933&Prime; box_blur=\u00a0\u00bbfalse\u00a0\u00bb]Avec votre don, nous serons en mesure d\u2019organiser des activit\u00e9s et de mobiliser les volontaires \u00e0 servir les personnes n\u00e9cessiteuses dans la ville de Bruxelles : des sans-abris ou des demandeurs d\u2019asile, des personnes \u00e2g\u00e9es, des personnes handicap\u00e9es, des enfants dans le besoin, et des victimes d\u2019abus.[\/mk_icon_box][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/3&Prime;][mk_icon_box style=\u00a0\u00bbsimple_ultimate\u00a0\u00bb rounded_circle=\u00a0\u00bbtrue\u00a0\u00bb icon_location=\u00a0\u00bbtop\u00a0\u00bb icon_color=\u00a0\u00bb#1e73be\u00a0\u00bb box_blur=\u00a0\u00bbfalse\u00a0\u00bb]Si vous avez constat\u00e9 l\u2019impact positif du volontariat \u00e0 STC, pourquoi ne pas faire un don financier pour donner l\u2019opportunit\u00e9 \u00e0 d\u2019autres de faire une diff\u00e9rence ?[\/mk_icon_box][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/mk_page_section][vc_row][vc_column][mk_padding_divider size=\u00a0\u00bb80&Prime;][mk_fancy_title color=\u00a0\u00bb#000000&Prime; size=\u00a0\u00bb30&Prime; font_weight=\u00a0\u00bb300&Prime; letter_spacing=\u00a0\u00bb1&Prime; margin_bottom=\u00a0\u00bb50&Prime; font_family=\u00a0\u00bbnone\u00a0\u00bb align=\u00a0\u00bbcenter\u00a0\u00bb]\n<p style=\"text-align: center;\">Vous \u00eates une entreprise ? Visitez notre page\u00a0<span style=\"color: #3366ff;\"><a title=\"rCSR\" href=\"https:\/\/www.servethecity.brussels\/fr\/corporate-volunteering\/\"><span style=\"color: #0098db;\">Corporate Volunteering<\/span><\/a><\/span>.<\/p>\n[\/mk_fancy_title][mk_padding_divider][\/vc_column][\/vc_row][vc_row fullwidth=\u00a0\u00bbtrue\u00a0\u00bb fullwidth_content=\u00a0\u00bbfalse\u00a0\u00bb css=\u00a0\u00bb.vc_custom_1600856128917{padding-top: 50px !important;padding-bottom: 50px !important;background-color: #fafafa !important;}\u00a0\u00bb id=\u00a0\u00bbFAQ\u00a0\u00bb][vc_column][vc_column_text css=\u00a0\u00bb.vc_custom_1580128978286{margin-bottom: 0px !important;}\u00a0\u00bb]\n<h3>Foire aux Questions<\/h3>\n[\/vc_column_text][mk_faq sortable=\u00a0\u00bbfalse\u00a0\u00bb orderby=\u00a0\u00bbmenu_order\u00a0\u00bb faq_cat=\u00a0\u00bbdonations\u00a0\u00bb][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row fullwidth=\u00a0\u00bbtrue\u00a0\u00bb fullwidth_content=\u00a0\u00bbfalse\u00a0\u00bb css=\u00a0\u00bb.vc_custom_1580331244408{padding-top: 30px !important;padding-bottom: 30px !important;background-color: #0098db !important;}\u00a0\u00bb el_class=\u00a0\u00bbwhite\u00a0\u00bb][vc_column][mk_fancy_title color=\u00a0\u00bb#ffffff\u00a0\u00bb size=\u00a0\u00bb48&Prime; font_weight=\u00a0\u00bb300&Prime; letter_spacing=\u00a0\u00bb1&Prime; margin_top=\u00a0\u00bb30&Prime; margin_bottom=\u00a0\u00bb40&Prime; font_family=\u00a0\u00bbnone\u00a0\u00bb align=\u00a0\u00bbcenter\u00a0\u00bb] Pour servir la ville, nous avons besoin de votre aide. [\/mk_fancy_title][mk_fancy_title tag_name=\u00a0\u00bbh3&Prime; color=\u00a0\u00bb#ffffff\u00a0\u00bb size=\u00a0\u00bb20&Prime; font_weight=\u00a0\u00bb300&Prime; margin_top=\u00a0\u00bb20&Prime; margin_bottom=\u00a0\u00bb0&Prime; font_family=\u00a0\u00bbnone\u00a0\u00bb align=\u00a0\u00bbcenter\u00a0\u00bb] Serve the City d\u00e9pend du d\u00e9vouement inlassable de milliers de volontaires qui investissent leur temps \u00e0 s\u2019occuper [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":7,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_crdt_document":"","footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-2887","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/pages\/2887","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/comments?post=2887"}],"version-history":[{"count":4,"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/pages\/2887\/revisions"}],"predecessor-version":[{"id":20918,"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/pages\/2887\/revisions\/20918"}],"wp:attachment":[{"href":"https:\/\/www.servethecity.brussels\/fr\/wp-json\/wp\/v2\/media?parent=2887"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}